In this study we aim to measure insulin resistance,glycemic control and the cardiovascular risk of obese patients with type 2 diabetes mellitus.
This was a descriptive cross-sectional hospital-based study conducted at Soba University Hospital, diabetes referred clinic, in Khartoum State, during the period from January 2015 to June 2015.Data was collected in a pre-designed questionnaire.Investigations of FBS, HbA1c and fasting insulin level and lipids profile blood samples (7 ml) were collected from fasting subjects of the study group.Calculation of insulin resistance (HOMA scale): HOMA-IR= glucose (mg/dl) x insulin / 405 m U /l The cardiovascular risk was calculated using the QRISK 2-2016 risk calculator. (pending analysis)
Out of the 200 patients included,The majority 63 (31.5%) had DM for less than 5 years, only 36 (18%) had normal BMI, while all the others were from overweight 80 (40%) to obese 84 (42%), and the majority 124(62%) had central obesity.High level of HbA1c% (> 7) was reported in 146(73%), whereas, 54(27%) had well controlled blood glucose.Insulin resistance was reported in 148(74%).There was a significant association between BMI, physical activity, higher level of HbA1c%, lipid profile, FBS, and insulin resistance and metabolic syndrome (P < 0.05).Poorly controlled DM and insulin resistance were significantly associated with overweight and obese subjects (P < 0.05).
IR and metabolic syndrome was associated in 54% of the patients. 71% of the patients had IR and obesity while 61% showed central obesity and those with poor DM control had high BMI.In this regard Aronne and Segal reported that insulin resistance increases with increasing body mass index, waist circumference and in particular waist-hip ratio. Previous studies showed that metabolic syndrome was found in 4.6%, 22.4%, and 59.6% of normal weight, overweight, and obese men, respectively, and in 6.2%, 28.1%, and 50.0% of normal weight, overweight, and obese women, respectively based on the NHANES III.The study of Fujimoto et al. in Japanese Americans over the last 10 years and studies emanating from the laboratories of Després show that visceral adiposity is the component of adiposity that is the independent risk factor for insulin resistance, glucose intolerance, and cardiovascular risk factors.
Good glycemic control and weight reduction in diabetic patients is of vital importance in prevention and improvement of insulin resistance, metabolic syndrome and cardiovascular outcomes in diabetic patients.
Consultant Internal Medicine and Endocrine,
University of Khartoum, SUDAN
Khartoum, Khartoum, Sudan
• Graduate of University of Khartoum, 1987.
• Currently, Senior Consultant, DM and Endocrinology
• Assistant Professor of Medicine, University of Khartoum.
• Head Department of Medicine, Soba University Hospital 2009-2017.
• Over 25 years experience in Internal Medicine, 19 years experience in DM and Endocrinology, with special interest in DM and the pillars of Islam, Medical Education and Basic Clinical Skills.
• Interested in clinical research in DM and Endocrinology.
• Member of Sudan Medical Council
• Member of Saudi Council For Health Specialties 2002 to date
• Former Academic Secretary (2011-2015) and currently Vice-President of Sudan Diabetes Association (SUDA).
• Academic Secretary (2014-2017) of the Sudan Association of Physicians (SAP).
• Founding Member and General Secretary of Sudan Endocrine Society (SUDES) 2010 to date.
• Member of the Arab Diabetes Forum. (ADF) 9/2011 to date.
• Vice-president of the 5th Insulin Therapy Summit, Arab Diabetes Forum (ADF), 2018
• Member of the International Diabetes Federation- Diabetes and Ramadan (IDF-DAR) International Alliance. (2013 to date)
• Member of the Arab Association for the Study of Diabetes. (AASD) 9/2013 to date.
• Member of the American Association of Clinical Endocrinology. (AACE) 7/2015 to date.
• Special interest in DM and Ramadan, and co-author in the 2016 IDF DAR International Guidelines.
• Co-author in the Diabetes and Hajj 2018 International Guidelines.
• Attended many National, Regional and International Workshops and Conferences in DM and Endocrinology.
• Speaker and Chairperson in a number of National, Regional and International conferences in DM and Endocrinology.
• Organized a number of Workshops, Symposia and Conferences on DM and Endocrinology.
• Working on research on DAR and other local DM and Endocrine-related issues.